In the shadows of the stage, resilience takes its brief respite.
The Physical and Psychological Dynamics of Professional Ballet
Performing arts, particularly professional ballet, require a unique combination of physical and mental attributes that come both naturally and are developed through consistent hard work. While the beauty and artistry of ballet can be awe-inspiring, the culture of the industry can also take a toll on dancers' physical and mental health. Dancers are often revered for their talent, athleticism, perseverance, and discipline. They are also expected to possess a certain level of mental fortitude to withstand the intense pressures both physical and emotional that come with their profession. While much emphasis typically has been placed on developing strong physical technique and artistry, it can be argued that not enough attention has been paid to cultivating the mental skills needed to succeed in the performing arts.
Unlike physical attributes such as a dancer’s physique and innate talent, mental strength is not something that can be assumed to come naturally or be present in every aspiring artist without being taught and cultivated. There is a pressing need for the incorporation of mental skills training programs that can help young dancers develop the inner resilience and psychological flexibility necessary for a successful career in the performing arts. Without such support, the risk of burnout, injury, mental health issues such as anxiety and depression, and early retirement from the field remains high. In this article, we'll explore the unique culture of professional ballet and why mental skills training and mental health support are crucial for dancers' well-being and success in the field.
Initiating Change To A Culture Rooted in Tradition
Uniformity in grace: Ballet's timeless tradition at the barre.
Training to become a professional dancer involves a strict class and rehearsal schedule. Daily classes are designed to help a dancer develop the precise technique and style that is expected in a professional company, which will enable them to perform any role that they are cast in. Young dancers will do many repetitions of certain steps over and over again to build strength, stamina, and to perfect their execution with each try. Many of the combinations given in a class may come from a curriculum that was established decades ago when the school was formed.
It’s important to recognize that the physical demands of a company dancer have increased over the last few decades, with dancers rehearsing more than 36 hours per week and performing anywhere from 3-6 nights per week. Additionally choreography is constantly evolving, demanding more challenges to develop greater athleticism, strength and stamina. Dancers have been found, on average, to suffer 6.8 injuries per year, comparable to American Football players. The increasing physical demands have demonstrated that the training gained from the traditional regime of daily classes and rehearsals may not be enough to sufficiently condition the dancers’ bodies to withstand the physical demands that they face.
Traditionally, dancers have often found themselves responsible for seeking additional training during their own time to address personal areas of weakness, injuries, or work on the appearance of their bodies, whether it involved physical therapy, private classes, pilates, or gym workouts. However, the traditional old-school regime often discouraged dancers from engaging in outside exercise or private classes, as it was believed to potentially interfere with the desired technique training or alter the desired physical aesthetic of the dancers' line. Additionally, the toll on dancers' bodies from spending extra hours in training and conditioning outside of the classroom could lead to further fatigue or injuries, which has been evident in the statistics. Current research states that 36% of dancers retire prematurely due to injuries, and 91% continue to experience pain even after their careers have ended. However, despite the adherence to tradition, certain companies and schools have recognized the value of incorporating conditioning training in addition to the traditional curriculum into their dancers' repertoire.
Incorporating additional physical conditioning training based on dance science is slowing becoming the norm in dance training.
Notably, more prominent and well-funded companies like the Royal Ballet have taken proactive steps by employing dance medicine teams under the guidance of the National Institute of Dance Medicine and Science (NIDMS). These teams assess the demands of the repertoire and design programs aimed at reducing injury rates among the dancers while simultaneously improving their strength and stamina. By tailoring the training programs to cater to the dancers' unique physiological needs, the dancers gain confidence in their abilities and receive the necessary support to thrive in their careers with fewer injuries. The idea is to incorporate the training around the dancers’ demanding schedules so that they are mindful not to overwork their bodies. For example, training may become more frequent and intense during a slow rehearsal period, and ease off during an intense performance run.
Other schools and companies are following suit. Joseph Gatti, Founder and Artistic Director of United Ballet Theatre in Orlando, FL, has developed his own program geared towards enhancing the performance abilities of his dancers, while being mindful of over training. Recognizing the importance of treating dancers as "athletes of art," Gatti has implemented a comprehensive core regimen within his company. He states, “Every ballet company begins its day with a ballet class, it is fantastic at teaching technique and coordination. However, Sports & Dance Science shows us that ballet class alone is not enough to recreate the demands of performance. This leaves dancers vulnerable to injury, especially when tired. Most of the injuries dancers get are around the lower limbs and are due to overuse. To make sure our Athletes of Art are robust enough for their workload, while still giving ample time for recovery- we find and utilize unique cross-training methods with certified professionals as part of our weekly schedule in conjunction with regular rehearsals.”
Gatti's proactive approach not only highlights his commitment to the well-being and longevity of his dancers' careers but also reinforces the growing realization within the dance community of the benefits derived from incorporating athletic training principles into traditional ballet practices. By recognizing and addressing the unique physical needs of dancers, Gatti empowers his company members to meet the rigorous physical demands of their craft and reach new heights in their performances while reducing the risk of injuries. One study taken over a year, demonstrated that by implementing dance science training reduced the injury rate by 82% as well as increased the time between injury occurrences by 45% (Vera et. al).
The Missing Piece
It can be difficult to be heard or feel supported when your therapist doesn’t understand the nuances of the pressures associated with the dance world.
Despite the growing recognition of the importance of sports science in ballet companies, there appears to be a notable gap when it comes to incorporating the development of mental skills training. While efforts have been made to enhance dancers' physical abilities and optimize their performance, the mental aspect of their craft remains relatively overlooked. There's an urgent demand for mental skills training initiatives that equip young dancers with the psychological strength and adaptability essential for a thriving career in the performing arts. Just as physical conditioning aims to prevent injuries and enhance strength, mental skills training can provide dancers with tools and strategies to enhance their mental well-being, optimize their focus and concentration, regulate performance anxiety, and develop a resilient mindset. Dancers can benefit from mindfulness techniques to manage stress and enhance focus, visualization to improve performance, and positive self-talk to build confidence. Mental skills training can help dancers manage the pressures and demands of the industry, and build resilience in the face of setbacks. With the inclusion of this training and support, the chances of burnout, injury, and premature departure from the profession can be significantly reduced.
Furthermore, there is a need for mental health professionals who work with dancers to have an understanding for specific values and pressures within the culture. One of the reasons that mental health is not something that is addressed in ballet, is that the culture that surrounds the art is rooted in tradition, focusing only on developing the technique and artistry of the dancer. The culture also adopts the mindset that to be a dancer is to embrace the challenges both physical and mental, and see them as an expected part of the dancer’s life. The very fact that a professional dancer’s extraordinary abilities come from such disciplined hard work and perseverance through challenges, is what sets them apart from the spectators, and is often a point of pride in their identity as an elite performing artist. There is a mentality of “If it were easy, anyone could do it,” which perpetuates the expectation of a higher level of challenges both physical and mental. It’s not unexpected that professional dancers and elite athletes exhibit a significantly higher prevalence of mental health disorders, including depression, anxiety, eating disorders, and stress, compared to the general population (Van den Eynde et al., 2016; van Rens & Heritage, 2021). However, athletes who have been found to score high on the General Anxiety Scale-7 (GAD-7), have not reported that they suffer from anxiety, demonstrating again that they have normalized their feelings as part of the culture.
The dance culture has several unique aspects that can contribute to a higher risk of mental health struggles for young dancers, particularly those in their formative years. One aspect is the experience of young dancers moving away from home to pursue their studies, often leaving behind their core support system of family and friends. Immersed in the dance world, they live, eat, sleep, train, and even attend academic school alongside their fellow classmates, creating an environment where their identity as a "dancer" becomes a central focus of their lives.
This intense immersion in the dance world can have both positive and negative effects. On the one hand, it allows for a concentrated focus on honing their skills and developing their artistry. However, it also means that the young students may face challenges in maintaining a balanced sense of self-identity. Their entire lives may revolve around their pursuit of dance, which can place immense pressure on them to succeed and meet the high expectations of the industry.
The absence of familiar support networks, such as family and lifelong friends, can further exacerbate the vulnerability of young dancers. They may experience feelings of isolation, homesickness, and a loss of connection to their roots. The intense training and competition within the dance world can also foster an environment where comparison and self-criticism are prevalent, increasing the risk of developing mental health struggles such as anxiety, depression, or eating disorders.
Recognizing these unique challenges, it becomes crucial to create a supportive framework within the dance culture. Dance institutions and organizations should prioritize providing comprehensive mental health support and resources for young dancers. This includes access to trained professionals who understand the specific demands and pressures of the dance industry. Additionally, fostering a sense of community, encouraging healthy competition rather than toxic comparison, and promoting open conversations about mental health can all contribute to a more nurturing environment for young dancers.
Hesitation in Seeking Mental Support: Why Dancers Struggle Silently
When the pain isn't in the muscles but the mind: It's easier to dance through physical pain than to speak of mental or emotional challenges.
When dancers begin to struggle with mental or emotional challenges, they may see it as a weakness, and they will try to push through it while often developing feelings of shame or inadequacy. Due to the culture of competition that is fostered in the performing arts, dancers may feel hesitant to open up about their challenges and struggles to their colleagues or mentors, fearing that they will be seen as weak or incapable of handling the demands of their profession. They may be afraid of how this could affect upcoming casting or contract opportunities. Therefore the dancer may choose to suffer in silence and be determined to “tough it out.”
It's imperative to pivot from this mindset and establish a culture of support that eradicates the stigma associated with mental health issues. In such an inclusive and supportive environment, dancers should feel empowered to express their concerns and challenges without fear of reprisal or judgment. Beyond the undeniable benefit of prioritizing mental well-being, this culture of support and understanding directly contributes to improved performance. An empowered and mentally supported dancer is not only more resilient but also more likely to reach their peak potential on stage. By fostering this environment, we're not just safeguarding their well-being; we're also enhancing the quality and longevity of their contributions to the performing arts.
Another common fear for dancers who may be struggling with mental or physical illness, is the fear of missing an opportunity or falling behind. Dancers will often rehearse and perform with an injury so that they are not replaced by another dancer. Some may justify the action by rationalizing that they can take time to recover during the break after the performances have ended or during the weekend. In smaller companies, a dancer might feel added pressure to perform sick or hurt especially if they do not have an understudy for a role, feeling like there is no choice but to perform. It’s important to recognize that there are teachers and directors, who genuinely do care about their dancers' physical and mental state, and try to foster a nurturing environment while challenging them to reach their potential. Sometimes, the pressures that dancers perceive come from within and how they interpret their situation. Mental health practitioners can help dancers identify faulty thought patterns that get in the way of their performance and cause them unnecessary distress.
Dancers, skilled in the art of performance, have a tendency to conceal any personal struggles they may be enduring. They possess the ability to maintain a facade of strength and composure, making it challenging to detect when something is wrong. The problem may only become apparent when physical manifestations such as a decline in performance quality, significant weight loss, or injuries occur. These signs of struggle are often overlooked or mistakenly attributed solely to the need for additional physical training. Alternatively, the focus may shift towards identifying the presence of an eating disorder, as it is one of the more commonly acknowledged mental health issues associated with dancers. As dancers are three times more likely than non dancers to develop an eating disorder van Staden et al. (2009), it has become almost an expected issue to occur in the culture.
However, when addressing potential mental health issues concerning a dancer, it's imperative not to jump to conclusions based solely on their profession. While their career demands might present certain predictable strains or challenges, every individual's experience is unique. Making assumptions without thorough evaluation not only undermines the individual's experience but also poses the risk of overlooking a critical diagnosis. Such oversight can lead to inappropriate treatment plans and insufficient support, further exacerbating the dancer's condition. It's essential to approach each dancer holistically, understanding the breadth and depth of potential factors contributing to their current state, ensuring they receive the precise care and support they deserve
A New Direction and approach
The evolving world of ballet stands at a pivotal juncture. It's evident that while dancers' physical prowess is often celebrated, their mental and emotional challenges can be overshadowed. To protect the future of ballet and the artists who dedicate their lives to it, a holistic approach to mental well-being must become the norm rather than the exception. It's not enough to train the body; developing the mental skills to thrive within the culture, by training the mind is equally crucial. The increasing demands and intense competition in ballet can result in a greater vulnerability for mental health struggles. Incorporating structured mental skills training can help dancers navigate these challenges. Mindfulness, resilience training, and coping strategies should be integral to a dancer's education, ensuring they're mentally equipped to handle the pressures of their profession. An approach that not only hones physical technique but also nurtures and empowers the mind. An approach where a dancer's mental health is given as much attention, care, and respect as their technical and artistic development.
Reinventing the support system for dancers is a collaborative effort, but there are resources available. Large organizations like National Institute of Dance Medicine and Science (NIDMS) and International Association for Dance Medicine & Science (IADMS), play pivotal roles in ensuring that the dance community is equipped with the latest research and best practices in dancer health and performance optimization.
NIDMS is a collaborative partnership of leading healthcare providers, dance organizations, and academic institutions. Its primary aim is to enhance the health, well-being, training, and performance of dancers by cultivating educational, medical, and scientific excellence. This is achieved through research, health promotion, and providing specialist medical services tailored to dancers' unique needs.
IADMS is a global organization dedicated to the advancement of dance medicine and science. It brings together medical professionals, educators, dancers, and researchers to promote the health, well-being, and performance of dancers. IADMS achieves this through fostering interdisciplinary collaboration, disseminating information via conferences and publications, and developing educational materials tailored for the dance community.
Mind the Gap, founded by Kathleen McGuire offers valuable insights, partnering with dance institutions to assess, advise, and implement holistic support structures while specifically focusing on the advocacy of mental health support in dance culture. By tapping into such specialized resources, dance companies and schools can create environments where physical and mental well-being are given equal precedence. Danscend, founded by Kristin Deiss and Michelle Loucadoux, is another organization, which provides education and support for dance educators in the form of workshops and consultations in order to put dancer’s mental health at the forefront of dance education.
In addition to these organizations, when directors and teachers look for potential resources to bring on board, it is helpful to look for therapists who have a background in sports psychology because they are more adept at understanding the mental pressures and dynamics that dancers face, from performance anxiety to the intense competition. Their skill set is tailored to optimize an individual's performance while ensuring mental well-being. They offer tools and strategies that can help dancers build resilience, maintain focus, regulate anxiety, and navigate the complex emotional landscape of the performing arts world. Therapists who also have experience specifically within the dance world such as Dr. Linda Hamilton, a former dancer with New York City Ballet turned psychologist, are also invaluable as resources for support, as they understand the specific nuances associated with dance culture.
In creating an environment where dancers are equipped, both physically and mentally, to transcend challenges and reach their zenith, we don't just preserve the longevity and well-being of these artists. We elevate the very art of ballet to new, unprecedented heights. An art form where each step is powered not just by rigorous training but by a spirit that is resilient, empowered, and free.